Primary care sits at the center of medicine and yet no one seems willing to truly own it.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Lisa Rosenbaum, cardiologist and national correspondent for the New England Journal of Medicine, for a wide-ranging conversation about why primary care remains both indispensable and persistently undervalued.

🎧 Before you go any further: If this conversation resonates, make sure you also listen to Lisa’s excellent NEJM podcast, Not Otherwise Specified. It’s one of the most honest, intellectually rigorous explorations of modern medicine and this past season focuses deeply on primary care.

Lisa has spent the past year reporting on primary care across the country, and what she uncovers isn’t a story about technology gaps or workforce shortages. It’s a story about culture. About respect. About responsibility. Together, Graham and Lisa explore how modern incentives have quietly shifted medicine away from ownership - of patients, of decisions, and of outcomes - and why primary care has absorbed the consequences more than any other specialty.

They dig into uncomfortable but essential questions:

Why is the specialty that knows patients best paid and respected the least?
How did “referral culture” replace continuity?
And what happens to trust between doctors, and between doctors and patients when no one is clearly responsible anymore?

Lisa argues that the crisis in primary care is not inevitable, and not intractable but only if medicine is willing to confront its own values.

This episode isn’t about nostalgia.

It’s about deciding what kind of profession medicine wants to be.

What You’ll Learn

Why the crisis in primary care is fundamentally about respect and ownership, not technology
How modern systems discourage physicians from fully “owning” their patients
The hidden costs of referral culture and fragmented responsibility
Why restoring autonomy may be essential to saving primary care
What gives Lisa hope—and why cultural change is still possible in medicine

Resources & Where to Find Lisa

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📝 For a full transcript of this episode click HERE

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